Management of grief

This article classifies grief into uncomplicated and complicated grief. A review of the psycho-analytic literature, recent studies on incidence, stages and developmental aspects of normal grief, the phenomenology and psychopathology of complicated grief, and the total management of grief amongst psychiatric patients, is presented. Complicated grief, classified as delayed, prolonged and distorted grief is described. As there is increased morbidity and mortality, the need for psychiatric intervention is necessary. The treatment of pathological grief includes grief counselling, brief dynamic psychotherapy, group psychotherapy, and family work. In addition to psychotherapy, for mental illness accompanying grief, biological treatment such as drugs should not be avoided. Therapeutic work with bereaved patients include the empathic approach, active listening, encouragement of verbal expression of affect, giving permission to grieve, and maintenance of therapeutic neutrality. Adequate attention must be given to analysis of counter transference and case supervision of the student therapist.